Frontline Health

#088 - Beyond the Diagnosis: New Perspectives on ADHD and Environment

• Troy Duell

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The way we understand and treat ADHD is undergoing a revolutionary shift, and it's high time we talked about it. What was once diagnosed in just 1% of children in the 1980s now affects approximately one in every 15-20 kids – about 6 million U.S. children in total. But does this explosion in diagnoses reveal an epidemic, or simply our broadened definition of what constitutes attention deficit?

Recent research highlighted in the New York Times has begun to challenge long-held beliefs about ADHD. The condition defies simple categorization – one child might be bouncing off walls while another sits perfectly still yet mentally disengaged. This spectrum of presentation makes diagnosis particularly challenging, especially when largely based on subjective questionnaires completed by teachers who may only see a child in limited contexts. Boys, naturally more active and hands-on in their learning styles, are diagnosed at significantly higher rates, raising questions about whether we're pathologizing normal developmental differences rather than addressing educational environments that fail to accommodate diverse learning needs.

Environmental factors appear to play a far more significant role than previously acknowledged. A fascinating University of Central Florida study demonstrated this perfectly: the same child who couldn't sit still during a math video remained perfectly focused while watching Star Wars. Diet (particularly artificial dyes and sugar), digital overstimulation, and even nutritional deficiencies can manifest as ADHD-like symptoms. Perhaps most telling is that many children "grow out" of their ADHD diagnosis – something unlikely if it were purely a neurological condition. Meanwhile, stimulant medications, while effective, come with serious side effects including cardiovascular changes that require careful monitoring. Should we really be so quick to medicate children when adapting teaching methods might better serve their needs?

Rather than viewing ADHD as purely a deficit, we're beginning to recognize its potential advantages. Many highly successful entrepreneurs, military personnel, and emergency room physicians have ADHD diagnoses, suggesting these traits can be tremendous strengths in the right environment. As parents and educators, we can help these children thrive by advocating for learning approaches that embrace movement, hands-on activities, and engagement tailored to their natural tendencies. Take ownership of your health and the health of your children by questioning one-size-fits-all diagnoses and exploring comprehensive approaches that celebrate different learning styles.

Thanks for listening to this edition of Frontline Health by Centurion. Remember, you are your best health advocate.

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Evan Patrick:

Today on the Frontline Health Podcast.

Troy Duell:

It's interesting that people who have been talking about this condition for 30 years are starting to go you know, maybe this isn't the way we need to be treating these people. Maybe it's the way we teach them, maybe it's the way we interact with them and we change that, and I think that's one of the best things that we've seen in the last couple of years regarding this condition.

Evan Patrick:

Hey everyone, welcome back to the Frontline Health Podcast by Centurion, where we bring you health news, tips and insights to help you take ownership of your health and your life. I'm Evan Patrick, and with me is founder and CEO of Centurion Health, troy Duell, and today we're diving into a condition that's often misunderstood, heavily medicated and incredibly common ADHD.

Troy Duell:

Yeah, and it's really amazing because it seems to have come back to the forefront again this week, because there was a recent article, I think earlier this week, in the New York Times that was titled Five Takeaways from New Research About ADHD, and it really kind of goes in to suggest that maybe some of those old assumptions we had about ADHD have been turned upside down and we need to start thinking about it and looking at it totally different. So that's one of the reasons we wanted to dive into this topic, because it's something that we're passionate about and I think that most people want to know what's going on with it.

Evan Patrick:

So let's actually start with this. Adhd is not easy to define, so let's talk about what it is and maybe what it isn't. One of the biggest takeaways from the article you just referenced is just how wide the spectrum of symptoms can be, so you can have two people with ADHD who might look completely different.

Troy Duell:

Absolutely, and I think a good starting point is to come back and say well, how many kids are really being affected by this? You know, in the 80s, when this started to come around, it was one out of every hundred.

Troy Duell:

Now, it's in the realm of one out of 15, one out of 20 that are starting to get diagnosed with it. So about 6 million kids in the US have been diagnosed with ADHD, and part of the reason for that is because it is so broad in the definition of ADHD. So one kid who's bouncing off the walls can be defined as ADHD, and then another kid who may be sitting totally still but zoned out can also be defined as ADHD. And I think that's where the difficulty really comes up with physicians, with parents and even with teachers, because they're the ones dealing with it head on is how do we differentiate between ADHD and boredom in the classroom? Because that's a big deal.

Evan Patrick:

Yeah, and you know, I think so many people have questioned themselves, wondering if they're ADHD, when they've had issues with focus or getting distracted or whatever the case may be, because everyone deals with those things at some point or another, which?

Troy Duell:

is a great point because we saw during COVID that the increase in ADHD testing and the people who thought they had ADHD went up about 20% year over year from the time before, where same people but they were put into a different environment where maybe they have their kids at home and they're trying to work. Of course you're going to have ADHD. You can't focus near as well.

Evan Patrick:

You're overstimulated, that's right.

Troy Duell:

When you have kids around or you have more distractions and hey, I can go ride my bike now or I can sit here on a computer and do some work. So it only makes sense that we'd all get kind of confused by that definition.

Evan Patrick:

For sure, and the more we learn, the more we realize that what we used to call ADHD it might actually not just be ADHD but a cluster of conditions or responses to different environments, as you kind of just hinted at For context.

Evan Patrick:

I don't think a lot of people understand how ADHD and many other mental health conditions are actually diagnosed by physicians. A doctor sits down with a child and their parents. They ask them a series of questions, and I mean, even as a former teacher, I've had to fill out questionnaires for kids that potentially had ADHD to help with the doctor's diagnosis. They try to get feedback from parents and teachers and other people who are around their kids, around those kids parents and teachers and other people who are around their kids, around those kids. My observation of them as a high school teacher was limited to one hour per day and it was history class. So, lo and behold, a lot of those kids are going to zone out right, history is not always the most riveting thing to every kid. So, troy, what do you think are some of the shortcomings of this method where we're diagnosing kids and putting them on medications based on questionnaires?

Troy Duell:

Yeah, I think that medication piece is really the scariest part, because we're not just putting them on medications, we're putting them on Adderall, which is speed, I mean it's a stimulant.

Troy Duell:

So it's something that can be devastating to people's health and has had devastating consequences. The other issue is boys are different from girls. I know that is a huge realization and a big piece to share this day and age, but boys are different than girls and you're right. If there's a class that a boy's in and he's bored or doesn't like, boys are naturally more fidgety. They like to get up out of their seat. They're more active. So I think the school system is a very difficult place to do that. And then if you lump in the fact that as a teacher, what you really wanted was order and you wanted people to stay in their seats, because if they're out of their seats you really can't get things- done.

Evan Patrick:

You can't let 30 kids all be doing their own thing. You've got to get everybody on the same page, exactly.

Troy Duell:

So, yes, if that's the case and that's the standard of the questionnaire you're looking at of is this kid getting out of their seat over and over then yeah, that's a little different from the others, but I think there are other ways that we can go in and change that, because schooling and the school system and the way we've set it up really is not a benefit to those kids, especially boys, who are more active and maybe have a greater creativity to them. I think there was one study that they shared from the University of Central Florida where they sat the same kid in front of a video screen and they were talking about math and they sat him in front of Star Wars.

Troy Duell:

Well in front of Star Wars while he was sitting there, he didn't fidget, he didn't do anything. He was totally in tune with what was going on, where the same kid, when he was watching 10 Minutes of Math, was spinning in his chair, was playing with his pencils, playing the drums, doing all kinds of things. Yeah, but it was all a matter of what really drew his attention. And I mean, let's be honest, who wouldn't rather watch Star Wars than math?

Evan Patrick:

Yeah, and if they can focus on something like that, it's probably not an attention issue, it's a boredom issue more than anything else 100% agree and if you would have asked me when I was a teacher, I would have told you that I had a lot more kids with ADHD after lunch, because those classes after lunch were always brutal Kids. You know, they've had lunch, they've got some energy, they're ready to go home for the day and they start to act out because they're bored from having been sitting still all day in classrooms.

Evan Patrick:

Yep, for sure. So do you want to talk about how our understanding has shifted in recent years?

Troy Duell:

Yeah, I think that article did a great job of really stepping in and showing that doctors who 30 years ago thought this was the way this is the truth have now started to shift their thinking wasn't necessarily that everything was wrong with what they were talking about, but it was kind of incomplete and that we're learning that the ADHD piece really is more about our environment and how we interact with our environment than it is necessarily an issue or a condition of that kid. And I think, as we continue to grow and see those things, it's interesting that people who have been talking about this condition for 30 years are starting to go. You know, maybe this isn't the way we need to be treating these people. Maybe it's the way we teach them, Maybe it's the way we interact with them and we change that, and I think that's one of the best things that we've seen in the last couple of years regarding this condition.

Evan Patrick:

Yeah, I mean this really speaks to what science is big picture in general. Right, I mean you can think of countless examples from in the past when there have been certain medical conditions that were treated a certain way.

Evan Patrick:

I mean, for goodness sake, we used to drain people of their blood, thinking that, that was going to help cure them of smallpox, and a lot of people ended up dying like that. So as we learn more knowledge, we have to change the way that we're treating things and be humble enough to admit hey, we were wrong before. This is what we can do, moving forward.

Troy Duell:

And I think that's key is that we've got to be willing to admit that we were wrong. And I think the other key is as a parent if you're going in and you've got a kid who maybe they've labeled as ADHD, really standing up for your kid and saying, hey, I don't know that he's ADHD as much as he is bored and he needs to interact in different ways and try to come up with those parameters of you know, don't just fall for whatever box they're trying to put your kid in and don't fall for whatever the medical community is saying. You know your kid better than that doctor does. You know your kid better than anything else. And if you've got a gut feeling that whatever's going on isn't right, then go with that gut and really start to push back a little bit.

Evan Patrick:

Yeah, and, to be fair, there are a lot of teachers out there who are coming up with just some really creative ways to help kids learn in all kinds of different ways, but at the end of the day, it's hard to compete with TikTok. Yep it is very hard. So what we thought was settled science, neurological imbalance, chemical deficiency, etc. Might actually be way more complicated. Researchers are now looking at how environmental factors like parenting, school structure, even diet and stress, could play just as big a role as brain chemistry.

Troy Duell:

Yeah, and I think the diet piece in particular is starting to come of age, as we hear RFK and conversations about red dye, number 40 and blue dyes and all the other dyes that we know are linked to increased incidence of ADHD and the symptoms of ADHD. We know that increased levels of sugar intake have an effect on people. So all these pieces we need to put in place and the environmental toxins if you have high levels of mold exposure, then sometimes that can come out as a ADHD type symptom. Or if you have low levels of iron, there can be ADHD symptoms associated with that. So I think it's one of those things that we don't need to just think in this tiny little piece, but we need to start looking at that child as a whole before we throw this label of ADHD on them and see if we can get to the root cause of these problems and not just throw a medication at them.

Evan Patrick:

So, with this increased understanding of the wide variety of causes that contribute to ADHD, let's talk a little bit about the treatment. Stimulants are still the go-to, and for a lot of people they work well, but we've got to be careful with them.

Troy Duell:

We do and I think probably the best way that I heard that characterized or a good example is yes, stimulants work, and I think stimulants work for just about everybody because it increases your awareness, it increases your heart rate and your blood pressure, so there are very few people that won't work for. Much like steroids will work for anybody who takes a steroid, but you're going to have differing levels. But just because a steroid works for you doesn't mean that you're weak or can't develop those muscles. It means that it's a shortcut to make those things happen. And it also comes with real side effects that need to be monitored, because stimulants are a dangerous thing to take on a regular basis. And we need to be very, very careful of what we're doing to our kids, because we know that stimulants can increase the blood flow, they can increase blood pressure and they can even blow out pulmonary arteries and make it to where it doesn't contract and expand the way that it was originally designed to do. So we've got to be super, super careful with the way that we treat kids.

Evan Patrick:

Yeah, and that's why the best approach really seems to be a comprehensive one. You know, there's nothing stopping us from combining meds with therapy, behavioral strategies, parent coaching, all kinds of different things, even physical exercise, not just handing out pills and hoping for the best. Many doctors will tell you that managing the dosing of ADHD medications, these stimulants, is extremely difficult, and it's kind of like walking a tightrope. At what point is someone able to get off their ADHD medication? I think that's a question that we need to be asking. Or do we just intend for them to stay on these stimulants for all time and have this incredibly difficult balance that the doctor is having to do, managing theircribing those stimulants?

Troy Duell:

a lot of them ask for a washout period of two to three months in order for your body to readjust, because our bodies aren't designed to be stimulated like that on an ongoing basis.

Troy Duell:

We also know that a large percentage of these kids who are diagnosed with ADHD quote unquote grow out of this condition.

Troy Duell:

And if you can grow out of a condition, you have to ask yourself is this really a condition or is this something that they've been labeled with? And they're a kid who has a higher level of activity and wanting to do things and wants to learn with their hands as opposed to being able to sit in a classroom? And I think we have to ask those questions because we do live in that age where everybody's got a phone at their fingertips You've got TikTok, you've got videos, you've got games, everything that's there is really an increased stimulus. So if you think about the things that they're seeing and they're interacting with, and then you try to put them in a classroom and say that they should be able to focus the same way they do in a classroom after they've been exposed to these other things, it's almost an impossibility. It really is amazing that more people don't struggle with it when you think about the amount of stimuli that's going on in their lives right now.

Evan Patrick:

Totally, and it makes you wonder how much of what we call ADHD today is actually just a reaction to our crazy, overstimulating environment.

Troy Duell:

Difficult time with paying attention and keeping up with things. So there is clearly an environmental factor that has to be put into play when you're talking about these things. If you take away the phones and you take away all those big stimuluses that are going on, then the likelihood that they're going to be able to focus in other areas will probably increase as they grow.

Evan Patrick:

Yeah, I don't think a prime example of this is the way that children's entertainment has been changing. I mean, have you ever seen a child watch Cocomelon, for example? And anyone who has can attest to the fact that our children's entertainment today, the new stuff that's being created, is designed to keep them as stimulated as possible. They have these fast cuts and it's just so different from what I remember growing up on with, like Mr Rogers teaching me how to be a good neighbor talking to the mailman, just this very calming sort of yes, entertaining presence, but just calming and nothing like what we're seeing with kids' TV shows today.

Troy Duell:

Absolutely, and I think it's a great case in point. I'm sure we've all been out to restaurants or we've been in other places where maybe the kid is really, really ramping up his activity, he's getting out of hand and all of a sudden you see mom or dad pull out the iPad. They look at the iPad and you don't see another peep or hear another peep out of that child for the rest of the iPad. They look at the iPad and you don't see another peep or hear another peep out of that child for the rest of the dinner. And they could be there two hours just mesmerized by whatever it is that's on there, and more than likely it's probably cocamelon or something similar to it, yeah, and I'm not a parent yet, so I can't judge just yet.

Evan Patrick:

Right now. I want to say that I will not raise my kids on iPads, but that's definitely something that is a lot more common now and it does work. It's like that digital pacifier, and we even do the same thing for ourselves. We don't really know how to be bored, I find myself. If I ever have to wait for anything for the slightest amount of time, I just kind of have to resist that urge to pull my cell phone out of my pocket and sometimes even just tell myself to just sit and breathe.

Troy Duell:

So true, so true, we are a creature of our culture and that iPhone is an easy thing to pull out if you've got an extra five minutes on you to catch up with news, to do whatever you need to do, instead of just taking it all in and enjoying your environment instead of just taking it all in and enjoying your environment.

Evan Patrick:

Well, here's the good news People with ADHD can thrive. There's more awareness, better resources and new science. That's really helping us understand the condition in a fuller way.

Troy Duell:

That is so true and there have been studies that have come out that have shown that a lot of the higher performing entrepreneurs, a lot of the higher performing men in military or women in military, were diagnosed with ADHD. And it really kind of makes sense because they're able to take on a lot of stimuli at the same time and also be able to process it and then move forward. And I think it's probably time that we begin to celebrate some of those differences and celebrate the opportunity that these people can come in and come up with, because if you think about an ER doctor, they are easily distracted and thankfully they are but they're able to keep all that stuff together. And if there are ways that we can tie in more of our entertainment, more of our education, and really start building those skills in those kids, I think they're going to be much better off. But our society and culture will be much better off too, because we'll have the talents that they bring and they're not shoved into a box and can't use those talents anymore.

Evan Patrick:

So how do you think parents of children with ADHD can help their children thrive?

Troy Duell:

I think the first thing is don't shame them when something's going on. Find physical ways to take out some of that energy, especially if they're a boy, and learn how to teach them with a more hands-on approach of things. Find out what it is that they really are gravitating to when it comes to education, and maybe that's a book that gets their minds thinking differently and has more action to it. Then get that to them so they can take it in and still read. But find something that really takes some of the boredom away.

Troy Duell:

And though I think we all gravitate to certain areas and if we can really hone in on that area that they're gravitating to and then work on those other areas that they're struggling with, with coming up with ideas of maybe it's a fiddle stick or some other thing that they can hold in their hand and just work through, Because I was reading as we went through this article that there are some that now show that if a child is actually moving something in their hand or being more active, that they're able to bring in that information in a way that they can process it and calculate it and do everything they need to do, but it just doesn't look the way that we think it should look as a society. So they just have a different way of learning and we need to embrace that and look for ways that we can work with their teachers and say, hey, if they're not being disrespectful, then let's work together to try to find a way that will help our child really do the best they can with what they're doing.

Evan Patrick:

Yeah, and that's really good advice for anybody. I've never been diagnosed with ADHD, but I've always done a lot better when I have a job or a task to do something to to keep me me from being idle and to to give me sort of a purpose. So if you're a parent or a teacher or someone with ADHD, we hope that this conversation encourages you to keep asking questions as we continue to learn more about what this condition really is and how we can help people with it. Don't settle for this one size fits all diagnosis or treatment plan.

Troy Duell:

Yeah, I think that's a great point and, you know, one of the biggest things we can do is really be an advocate for our kids or for our family members and understand, if something doesn't feel right, that we need to speak up and we need to talk about ways that we think would be better suited for our kids, because we certainly know our kids and we know our family members better than a doctor does or even a teacher does.

Evan Patrick:

We'll link the articles we talked about in the show notes, so check those out and if you got something out of today's episode, be sure to share it with a friend or leave us a review. It helps us reach more people. Thank you for listening to this episode of the Frontline Health Podcast by Centurion. As always, we encourage you go out today, take ownership of your health, because you are your best health advocate. Till next time, if you enjoyed what you heard today on the podcast, please consider leaving us a review. We would love to hear your feedback and connect with you further. You can also follow us on Instagram X, tiktok and YouTube, and for safe, effective and affordable health and wellness products made in the USA, visit wwwcenturionhealth. Thanks for listening. We'll see you next time.